December 2018 marks five years since the outbreak of the current conflict in South Sudan, which has resulted in an estimated 380,000 excess deaths, 4.4 million people displaced, substantial macroeconomic decline, and widespread acute food insecurity. Although the conflict was initially most severe in Greater Upper Nile, it intensified in many areas of Greater Equatoria and Greater Bahr el Ghazal following an eruption of violence in Juba in July 2016, and conflict still persists in parts of the country.

Acute food security has deteriorated substantially since the outbreak of conflict. By September 2018, the South Sudan IPC Technical Working Group estimated 6.1 million people were in Crisis (IPC Phase 3) or worse, nearly 4 times the 1.6 million people estimated in Crisis (IPC Phase 3) or worse in August 2013. The severity of acute food insecurity, as evidenced by the proportion of the population in Emergency (IPC Phase 4) and Catastrophe (IPC Phase 5), has also increased. Furthermore, at a number of times and locations there has been concern that extreme outcomes existed, but sufficient information to confirm or deny was not available.

Humanitarian food assistance has played a significant role in lessening food consumption gaps throughout the conflict. The monthly metric tonnage (MT) of food assistance delivered has increased by roughly 60 percent over the past three years, from around 15,000 MT per month in 2015 to around 24,000 MT per month in 2018. Despite this, the need is outpacing increases in humanitarian assistance delivery, and current food assistance needs are the highest on record.

As a result of the five-year conflict, large-scale humanitarian assistance needs are expected throughout 2019, and Famine (IPC Phase 5) would be likely in 2019 in the prolonged absence of humanitarian assistance. A notable decrease in conflict may be possible in 2019 given recent declines in violence in November and December and steps that are being taken towards implementing the September 2018 peace agreement. However, even in the event of a significant decrease in conflict in the coming year, extreme needs will persist as many households have lost access to typical food and income sources as a result of the conflict. Should there be high levels of conflict, food security would likely deteriorate even further, and Famine (IPC Phase 5) would be likely among populations who face severe restrictions to movement.